Coronary atherosclerotic heart disease (CAHD) refers to a sort of heart disease, which is caused by vascular stenosis or vascular obstruction due to the coronary atherosclerosis, or (and) by myocardial ischemia hypoxia or myocardial necrosis due to the coronary artery function changes (e.g. spasm). All of these are together called as the coronary heart disease (abbr. as CHD), also called as the ischemic heart disease. The CAHD is known as the most common type of atherosclerosis-induced organ pathology, which has also been a common disease seriously doing harm to human health.
Generally, the CHD is caused by coronary atherosclerosis. The onset of the CHD rises with age increase. The older the patients are, the more severe the diseases get. As confirmed by some data, since age of 40, possibilities of the CHD are increased by 1 time with each additional 10 years of age. There has a more rapid development of the coronary atherosclerosis in man after the age of 50, or in woman after 60. In the same way, risk of myocardial infarction is increased with the growth of age. In recent years, onset age of the CHD showed a low-age tendency. Now, the percentage of young people under the age of 35 suffering from the CHD is on the rise, and the youngest patent was only 20 years old. Due to its high incidence and high mortality, the CHD has become a disease threatening human health seriously. So it is called as the “first human killer”. Because none of symptoms can be in the least observed before the onset of the CHD, the consequence of some patents would be incredibly bad without timely emergency treatment. Accordingly, in terms of the CHD, prevention is more important than treatment.
Usually, the prevention of CHD includes the primary prevention, secondary prevention and triple prevention. Said primary prevention is targeted to the risk population who has not yet suffered from the CHD; the secondary prevention is to the patients who have been at the early stage of CHD; and the triple prevention is to prevention of occurrence of CHD progression and complications. In practice, prevention has become very important to both the CHD patients and CHD high risk population. Secondary prevention of the CHD refers to early discovery, diagnosis and treatment on the CHD patients. The objective of secondary prevention is focused on ameliorating symptoms, preventing deterioration of the disease, improving prognosis and keeping off the reoccurrence of the CHD. At present, there are two main measures used for the secondary prevention of CHD, the one is to find and control the risk factors; and another is the reliable and continuous drug therapy.
Prevention of the CHD should be comprehensively focused on various factors, including diet, exercise, medication, and controlling risk factors etc. Especially for the CHD patients, the objective of prevention is to ameliorate symptoms of disease, prevent its progress, and keep off its reoccurrence. Prevention of the CHD includes two “ABCDE”s, which take place at each stage of the disease. Only by insisting on the secondary prevention, the treatment is effectively targeted to the etiology with effective reduction of reoccurrence.
Of the first “ABCDE” of the secondary prevention of the CHD, “A” represents aspirin whose main effect is to prevent the formation of atherosclerosis by resisting platelet aggregation and release and improving the balance of prostaglandin and thromboxane A2. In clinic, routine administration of aspirin enteric-coated tablets, 100 mg daily, can prevent the reoccurrence of the CHD. The “B” represents hypertension, which can not only accelerate the speed of progression in atherosclerosis, but also increase its extent. The higher the blood pressure, the greater possibility of occurrence or reoccurrence of the CHD. Effectively reducing blood pressure may prevent the reoccurrence of the CHD. The “C” represents hyperlipidemia. On the one hand, the hyperlipidemia decreases the amount of blood supply in brain by making the blood viscous and slowing the blood-flow; on the other hand, it damages the vascular endothelium to such a degree that it is deposited on the vascular wall to form atherosclerotic plaque. All of these directly cause the occurrence and development of cardiovascular and cerebrovascular diseases. The “D” represents diabetes. More than 80% of diabetes results in abnormal lipid metabolism, which is often accompanied by cardiovascular and cerebrovascular diseases, e.g. the atherosclerosis and hyperlipidemia. Meanwhile, escalated glucose content in blood makes the blood viscosity and coagulation increased, rendering the diabetics very prone to develop the CHD. The “E” represents rehabilitation education. Popularity of education of hypertension, CHD and atherosclerosis prevention should be strengthened by the network publicity, free distribution of readings and regular rehabilitation instruction. By means of active intervention of risk factors, the patients are willing to accept the long-term prevention measures patiently, and active with drug treatment.
Of the second “ABCDE” of the secondary prevention of the CHD, “A” represents active physical exercise. Not only can the proper exercise increase fat consumption, but also reduce deposition of cholesterol in body and improve insulin sensitivity. It is helpful in following aspects: preventing obesity, controlling body weight, increasing circulation function, regulating blood lipid, decreasing blood pressure and reducing thromboses, which is known together as the active measures to prevent the CHD. Strenuous exercise is not suitable for patients, e.g. sprints and climbing. Aerobic exercise is recommended, e.g. jogging, walking, calisthenics and Tai Chi. “B” represents weight control. The BMI should be maintained or lost in the range of 18.5˜24.9 kg/m2 and waist circumstance less than 90 cm. “C” represents smoking cessation. Reportedly, there are more 3000 kinds of harmful substances in cigarettes. If the nicotine in smoke is inhaled into the body, it can stimulate the autonomic nervous, make the blood vessel convulsed, quicken the heartbeat, increase the blood pressure and blood cholesterol, thus accelerating atherosclerosis. “D” represents reasonable diet. The food should be varied and cereal-based. The dietary recommended for the patients is present as follows: more magnesium-rich food, e.g. grains, nuts and seaweed; more cellulose-rich food, e.g. vegetables, bananas and potatoes; milk, beans or other products daily; a proper amount of eggs and lean meat often; and less fat meat, pork skin, hooves and meat dishes. Food intake and physical activity should be kept balanced, and a proper body weight maintained. Food should be salt and sugar-less, and amount of salt is reduced to 6 g a day. “E” represents emotional stability. Optimistic and stable emotion together with comfortable and balanced state of mind is important factors not only in preventing cardiovascular and cerebrovascular disease, but also keys and secrets to long life.
Clinically, the CHD is divided into five types in accordance with its site and scope, degree of vascular occlusion and the development speed, scope and degree of myocardial ischemia. 1. Latent CHD, also known as symptomless CHD, refers to those patients whose ECG, although showing no symptoms, have displayed changes of myocardial ischemia of ST-segment depression, reduced, flattened or inverted T-wave after resting or cardiac stress test. 2. Angina pectoris CHD refers to those patients who suffer from paroxysmal retrosternal pain caused by transient myocardial ischemia. 3. Myocardial infarction CHD has severe symptoms due to the myocardial ischemic necrosis caused by coronary artery occlusion. 4. Heart failure and arrhythmia CHD show symptoms of cardiac enlargement, heart failure and arrhythmia caused by myocardial fibrosis and heart enlargement due to longtime chronic myocardial ischemia. 5. Sudden death CHD always results in sudden death by primary cardiac arrest, which is caused mostly by severe arrhythmia due to electrophysiological disorder locally generated in ischemic myocardium, e.g. ventricular tachycardia and ventricular fibrillation.
At present, β-receptor blocker is mainly used for preventing the Angina pectoris CHD. It works for preventing attack of angina pectoris by decreasing myocardial oxygen consumption under the condition of exercise and tension. Its main contraindication is bronchospasm, bradycardia and decompensated heart failure. Hence, for the patients with asthma or other airway obstructive diseases, the β-receptor blocker would make them worse.
Recently, what have been used for preventing malignant vascular event is mainly focused on antiplatelet agents. They take effect of inhibiting adhesion, aggregation and secretion of platelet through a mechanism of inhibiting arachidonic acid metabolism and increasing cAMP level in platelets. Their main side effect is bleeding. Therefore, they are not used for the patients who suffer from blood coagulation dysfunction or ulcer diseases.
The present invention relates to a compound Salvia Miltiorrhiza composition, which has been developed on the basis of both traditional Chinese medicine (TCM) theory and modern pharmacological studies. According to the TCM theory, the pathologic basis of chest stuffiness and heart pain is failure of aiding the blood circulation in heart caused by stagnancy of blood stasis in heart vessel and poor blood circulation. After long-time of pharmacological trials and clinical studies, by means of formula selection, the inventor of present invention has developed aforesaid compound Salvia Miltiorrhiza composition having effects of activating blood by removing stasis, stopping pain by relaxing chest stuffiness and resuscitating with aromatic herbs. In this composition, the Salvia Miltiorrhiza is used as the monarch drug, Panax Notoginseng as the minister drug and Borneol as the adjuvant drug. Clinically, it is mainly used for treatment of angina pectoris CHD.